US20090149789A1

US20090149789A1 - Device to treat and/or prevent shoulder subluyation

Info

Publication number: US20090149789A1
Application number: US12/287,513
Authority: US
Inventors: Ying Chi Huang; Manuj Agarwal
Original assignee: Individual
Current assignee: Individual
Priority date: 2007-10-24
Filing date: 2008-10-10
Publication date: 2009-06-11
Also published as: US8192382B2

Abstract

A device intended to provide stabilization of a subluxed joint through a pneumatic air chamber combined with a plurality of straps designed to provide ease of use to the patient with a subluxed shoulder joint. This pneumatic sling will allow the user to operate this device with one upper extremity and improves independence to this population. The combination of the air chamber to the sling will provide added comfort by conforming to the discrepancies of an individual's body contours. The design of this invention with the manual pump and release valve will allow the ease of donning and doffing the device.

Description

The present application claims the priority benefit of U.S. Provisional application Ser. No. 61/000,009, filed Oct. 24, 2007

BACKGROUND OF THE INVENTION

This invention relates a device for prevention and treatment of shoulder subluxation in patients with neurological dysfunction, such as stroke, or a number of other conditions that would impair the stability of the glenohumeral joint.
A stroke is an acute onset of neurological dysfunction caused by a malfunction in cerebral blood circulation which results in functional deficits congruent with the corresponding focal areas that are involved. A large variety of clinical manifestations may occur including varying levels of consciousness, sensory, motor, cognitive, perceptual, and language deficits. For the purpose of this background we will speak of the motor deficits involved that deem this device necessary.
In the initial stages of this disease process the patient will be flaccid: the patient has no voluntary control, muscles lack tone, and movement is not possible. During this flaccidity period of the cerebral vascular accident proprioceptive control may be shut off. This combined with the lack of tone and muscle paralysis decrease the support and normal seating of the rotator cuff muscles, especially the supraspinatus. The ligaments and capsule now becomes the shoulder's sole support. With the weight of the arm and gravity these structures may become stretched out and thus result in a shoulder subluxation. The gravitational forces and constant traction will result in persistent misalignment which will later cause pain.
Due to the fact that a stroke often impairs one side of the body many patients will find it hard to operate a traditional sling or as a matter of fact any arm sling. The dexterity of the effected side is compromised and the use of the one good arm is often insufficient to tighten the sling; the present invention is developed to accommodate this problem.
U.S. Pat. No. 5,188,587 of McGuire et al. discloses a shoulder brace comprising a shoulder sleeve and a plurality of straps. While the device serves a rehabilative function for the shoulder joint, it does not conform to individual body contours and asymmetries. Furthermore, the McGuire et al. device does not adequately serve the function of treating shoulder subluxation for there is no means of adequately lifting the humerus into the glenoid fossa. Rather, strap 206 is shown to depress the acromioclavicular joint which may cause further orthopedic problems.
U.S. Pat. No. 4,446,858 of Verter discloses a shoulder brace that serves to support the arm and shoulder in the event of lack of muscle tone and ligament integrity, as is the case in shoulder subluxation. While the device adequately serves this purpose, it does not allow the user ease of independent application without the help of another individual. Similar to McGuire, the device does not contour to different body shapes and asymmetries. This may result in areas of increased pressure which may cause pressure ulcers in patients with reduced tactile sensation. Indeed, pressure applied by the device is not uniform over the applied area.
It would be advantageous to the shoulder subluxation patient if the aforementioned deficiencies were addressed. It is the object of the invention to provide a shoulder brace that will maintain the integrity of the shoulder joint. It is a further object of the invention to provide a brace that will provide ease of independent use. It is a further object of the invention to provide a brace that will adjust to an individual's body counters and asymmetries to provide uniform support of the shoulder joints. It is a further object of the invention to provide a shoulder brace that will maintain the position of the humerus in the glenoid fossa and prevent shoulder subluxation.

SUMMARY OF THE INVENTION

The purpose of this invention is to aid in the reduction of a subluxation that one may have upon suffering a cerebral vascular accident also known as a stroke. Although slings for shoulder subluxation have already been developed, this invention differs from the prior art in many ways. The components in this device greatly add to the comfort of the wearer for it provides functional adaptations that improve the ease of independent use.
The component innovations in this device include one or more air chamber(s) that contours and conform to the shoulder region, strategically placed chest, shoulder and elbow straps that provide shoulder support that reduce subluxations at proper vectors. Said chambers possess a manual inflation means and releasing means existing on the external surface, as well as a cushioning medium that contacts the skin.
The component air chamber(s) contours at the shoulder region and is situated on the deltoids and the upper trapezius muscle. It is made of an airtight material and is specifically designed to allow proper gapping that would accommodate to the variances in body shape and sizes. As it is inflated the chamber would provide a snug fit that is unobtainable in the prior art. Previously invented shoulder slings make use of adjusting straps; instead of adjusting straps that go around the arm this device inflates to the proper fit thereby eliminating unnecessary clips and straps that would cause unwanted points of pressure.
In addition to providing a snug fit, this device upon inflation provides a uniform area of pressure around the shoulder joint thus reducing the risk of pressure ulcers. Moreover, an elbow support will provide lift via elbow straps of the humerus into the glenoid fossa thereby reducing the shoulder subluxation and providing increased stability. As the chamber is inflated the shoulder is further brought up into the glenoid fossa. The component straps strategically placed at the chest, shoulder and elbow region provide the correct vectors that produces lift in the correct angles in this device. They allow support in the correct direction to maintain stability while providing comfort to the wearer.
The component manual inflation means existing on the external surface of the shoulder sleeve is specifically designed with the patient in mind. Upon having a cerebral vascular accident many patients find that they only have the use of one arm. With the development of this innovation the wearer can adjust the shoulder sling on a day to day basis independently. The wearer only needs to use one or two fingers to inflate the chamber to the desired fit at the shoulder. The wearer only needs to use one finger to release the air in the sling by pressing the release valve; this provides ease with removal.
The advent of this light-weight device will not only reduce shoulder subluxation and allow easier access, functional independence with regards to the donning and doffing of the shoulder sling, greater acceptance and regular use which will be followed with greater compliance.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a view of the shoulder sling in accordance with the present invention as worn by a user

FIG. 2 is a perspective view of the anteriolateral portion of the shoulder sling.

FIG. 3 is an angled view of the shoulder sling as worn by the patient @ 40 degrees of flexion @ the right glenohumeral joint

FIG. 4 is an anterior view of the elbow elevating support in accordance with the present invention.

FIG. 5 is perspective view of the anteriolateral view of the shoulder sling with layers exposed

FIG. 6 is a cross sectional view of the shoulder sling

FIG. 7 is an exploded view of the shoulder sling

FIG. 8 is a view of the pump in accordance with the present invention

FIG. 9 is a view of the release valve in accordance with the present invention

PARTS LIST

100: Shoulder sling device
200: shoulder sling portion
300: elbow elevating support
400: open region
1: strap 1
1A: length adjusting means
1B: attachment element
1C: attachment retaining element
2: strap 2
2A: length adjusting means
2B: attachment element
2C: attachment retaining element
3: Strap 3
3A: length adjusting means
3B: elbow strap guiding element
3C: strap looping element
4: cushioning means housing wall
4A: cushioning means
5: interior textile layer
6: exterior textile layer
7: exterior textile layer
8: air bladder
9: continuous air bladder space
10: air bubbles
10A: Air bubble inlet
11: ventilation holes
12: cushioning means housing wall
12A: cushioning means
13: interior textile layer
14: inflation means
14A: collapsible inflation means housing
15: inflation means chamber
15A: inflation means retaining element
16: one way valve
17: one way valve
18: pressure releasing means
19: pressure releasing means housing
19A: pressure releasing means retaining element
20: pressure releasing air outlets
21: pressure releasing valve
21A: air passage means
21B: airtight lining means
22: buoyant pressure retaining means

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

With reference to FIG. 1, shoulder sling device 100 is shown as worn by a user in accordance with the present invention. Device 100 consists of shoulder sling portion 200 from which emerges a plurality of straps, namely strap 1, strap 2 and strap 3. Referring to FIGS. 1-3, strap 1 is shown to emerge from the most superior portion of shoulder sling portion 200, extend across the patient's dorsum, return anteriorly by crossing the patient over the left trapezius muscle, pass through length adjusting means 1A and loop into in attachment element 1B to return into the said length adjusting means. Attachment element 1B will be inserted into attachment retaining element 1C located on the anterior area of the device 100. The length of strap 1 may be adjusted via length adjusting means 1A by pulling on said strap 1. Similarly, strap 2 begins from a more posteriolateral location on the device, crosses the patients back, emerges anterior after crossing the patient's left axillary region to pass through length adjusting means 2A, loop into attaching element 2B and return to the length adjusting means. Attaching element 2B will be inserted into attachment retaining element 2C located on the anteriomedial of the shoulder sling portion 200. The length of strap 2 may be adjusted via length adjusting means 2A by pulling on said strap 2.
Referring to FIGS. 1-5, Strap 3 emerges from the lateral surface of the sling 200 and descends to length adjusting means 3A, after which it descends to the lateral surface of elbow elevating support 300 where it passes through elbow strap guiding element 3B. Elbow strap guiding element 3B may run through the partial or entire length of the said elbow elevating support 300. Strap 3 then emerges medially, ascends towards the medial surface of sling 200 and loops through strap looping element 3C (shown in FIGS. 3, 5) on said shoulder sling portion 200, after which it descends to reenter elbow strap guiding element 3B. From here it emerges laterally and enters length adjusting 3A once again. This orientation allows for length adjustment of strap 3 which will symmetrically raise said elbow elevating support 300.
Said straps 1,2,3 may be constructed from a variety of different materials, including but not limited to leather, cotton, nylon, elastic/non-elastic cord, shock cord, web, woven elastic, elastic lace, polyester, polymers, denim, braid, and/or combinations and/or mixes of said materials, or any other material obvious to one in the art. Similarly, said elbow strap guiding element may be constructed and/or coated with similar materials that allow for reduced friction against strap 3. Said attachment elements 1B, 2B, 3B, attachment retaining elements 1C, 2C, 3C, and length adjusting means 1A, 2A, 3A may be assembled from a variety of devices for attachment. This includes, but is not limited to a conventional prong belt buckle, web strap buckle, snap hooks, cam buckles, hook clips, adjusters, web strap slides, carabiners, luggage clips, hook and loops means (Trademark Velcro) or any other material obvious to one in the art.
Said straps, attachment and length adjustment means serve merely to initially mount the device 100 on the patient. An initial gross adjustment of the strap length will adjust the device to the patients overall size but will not provide any fine adjustment specific to an individual's body contours. Such fine adjustment will be discussed later.
With regard to the initial mounting of the device on the patient, refer to FIG. 5. Shoulder sling portion 200 is shown to be continuous through its circumference. The figure depicts a region that is drawn transparent to allow the viewing of open region 400. In this orientation, the shoulder sling portion will be initially mounted on a user by inserting the user's arm into the open region and sliding the device up the desired arm. Subsequent securing of the device will be achieved via the attachment of straps 1, 2, and 3 into their respective attachment retaining elements.
Referring now to FIG. 4, elbow elevating support 300 is depicted in an anterior view, as well as in coronal section to illustrate its various components. Beginning from its exterior, elbow strap retaining means 3B is shown to allow passage of strap 3 throughout its entire length. Interior to the elbow strap retaining means 3B is the cushioning means housing wall 4 which retains cushioning means 4A. Cushioning means 4A may be constructed of a variety of different malleable materials, including but not limited to different varieties of foam such as flexible soft polyurethane foam, as well as highly viscoelastic pliable polymer gel materials as found in gel seats and/or mouse pads. Cushioning means 4A will provide a comfortable cushion to the user's elbow. Exterior to the more interior cushioning means housing wall is an interior textile layer 5, which will contact the skin of the user's elbow region. This interior textile layer 5 can be constructed from a variety of different materials, including but not limited to cotton, polyester blends, neoprene, fleece, satin, suede, any other fabric or cloth, blends thereof as well as any other material obvious to one in the art. The equivalent of the interior textile layer 5 of the exterior surface of said elbow elevating support 300 is the exterior textile layer 6, which will be constructed of a less pliable material including but not limited to leather, cotton, nylon, wool, denim, polyester, polymers, blends and/or combinations thereof, as well as any other material obvious to one in the art.
Referring now to FIG. 5, an anteriolateral perspective view of the shoulder sling as worn of the left arm is shown with component layers exposed in a zoomed in section. These layers can be better visualized in FIGS. 6 and 7. FIG. 6 depicts a cross sectional view of the shoulder sling portion 200 depicting its internal structures, which can be seen better in the zoomed in portion of the figure. The exterior surface of the sling is lined by an exterior textile layer 7 that is similar in construction to exterior textile layer 6 of the elbow elevating support 300. The interior surface of the sling is lined by an interior textile layer 13 that is similar in construction to interior textile layer 5 of the elbow elevating support 300. External to the internal textile layer is a cushioning means housing wall 12 which contains cushioning means 12A. The cushioning means 12A is similar to the cushioning means 4A of the elbow elevating support 300. In a preferred embodiment, the cushioning means 12A consists of a highly viscoelastic pliable polymer gel material. This gel material is preferentially elastomeric with the consistency of fatty tissue, such as T-Gel, a trademark of AliMed. External to the cushioning means housing wall is a unique air bladder 8. Air bladder 8 is shown to comprise a continuous air chamber space 9 and air bubbles 10. These elements are better shown in an exploded view as depicted in FIG. 7. The air bladder is depicted in zoomed section which allows a better visualization of air bubble inlet 10A.
Referring to FIGS. 5-7, note that ventilation holes 11 extend from the interior aspect of the device to its exterior. These ventilation holes are not continuous with the air bladder 8. They pass through the air bladder between the said air bubbles. Said ventilation holes prevent the buildup of heat and sweat on the user's skin by allowing the escape of warm air and the subsequent physiological cooling. This aspect of the invention allows for greater comfort of use which will translate into greater compliance.
Referring back to FIGS. 1-3, an inflation means 14 is depicted on the anterior surface of the shoulder sling portion. Details of the inflation means are depicted in FIG. 8. Inflation means 14 is shown to comprise collapsible inflation means housing 14A, as well as one way valves 16 and 17, and is continuous with said air chamber 8. The said inflation means is depressed with a user's finger, a process which will cover one way valve 15 to prevent air in inflation means chamber area 15 from escaping into the atmosphere. The depression of the inflation means 14 will force the opening of one way valve 17 and allow entry of air into the continuous air bladder space 9 of air bladder 8. The inflation means 14 is held in place via inflation means retaining element 15A. This component passes through all layers exterior to the air bladder 8 and terminates at the said air bladder. It will not only maintain the integrity of the inflation means 14, but will allow the passage of said air into the air bladder without fail. Once the air enters the air bladder, it will travel to areas with a negative pressure gradient, with greater distribution to areas with a larger pressure gradient. During inflation, the air will enter said air bubbles 10 via air bubble inlet 10A as shown in FIG. 7. These bubbles will inflate until a point where they provide adequate and comfortable support to the patient's shoulder. In a preferred embodiment, the inflation of the bubbles will distribute and deform the cushioning means 12A and allow for a snug, comfortable fit. When the air bubbles are optimally inflated to adjust to an individual body contour, the pressure gradient will dissipate in this area and the inflated air will preferentially distribute to more distal air bubbles in need of inflation. Note that the dashed lines of FIG. 8 represent the ventilation hole 11 that passes through the air chamber 8 and is not continuous with said air chamber 8.
Referring back to FIGS. 1-3, a pressure releasing means 18 is shown on the anterior surface of the shoulder sling portion. Details of the pressure releasing means are depicted in FIG. 9, which depicts it in coronal section. Pressure releasing means 18 comprises a semi-rigid collapsible pressure releasing means housing 19 which is penetrated with a plurality of symmetric spaced pressure releasing air outlets 20. The pressure releasing means housing 19 contains a pressure releasing valve 21 which penetrates said air chamber 8. The pressure releasing valve 21 is maintained in an upright position via resilient buoyant pressure retaining means 22, which prevents air from escaping from the said air chamber 8. Similar to the inflation means retaining element 15A, the integrity of the pressure releasing means is maintained by pressure releasing means retaining element 19A, which also passes through all layers exterior to the air bladder 8 and terminates at the said air bladder. When a user depresses the pressure releasing means 18 with his/her finger, the pressure releasing means housing 19 will collapse and allow the depression of pressure releasing valve 21. The depression of the pressure releasing valve will compress the buoyant pressure retaining means 22 which will depress the tail of the pressure releasing valve and allow the escape of air up, through a plurality of air passage means 21A in the head of the pressure releasing valve 21 and out through the pressure releasing air outlets 20. When depression of the said pressure releasing means is released, the buoyant pressure retaining means 22 will cause the said pressure releasing valve to rise again. In this orientation, further escape of air from said air bladder 8 into the atmosphere is prevented, for the contact interface between the pressure releasing valve 21 and pressure releasing means retaining element 19A is inherently airtight.
The collapsible inflation means housing 14A, collapsible pressure releasing means housing 19, as well as buoyant pressure retaining means 22 may be constructed from any resilient, buoyant material such as rubber, polymers, and/or any other material obvious to one in the art. Said one way valves and pressure releasing valve 21 may be constructed of a metal, rubber, polymer or any other material obvious to one in the art. Moreover, said pressure releasing valve 21 may further comprise airtight lining means 21B, which may be constructed of similar materials to perform the desired function. Said air chamber and air bubbles may be made of an airtight polymer, rubber, and/or any other material obvious to one in the art. Said inflation means retaining element 15A, and pressure releasing means retaining element 19A may be constructed of rubber or any other material capable of performing the stated function that is apparent to one in the art, such that the inflation means and pressure releasing means, respectively, are maintained in position, and that interface between the pressure releasing valve 21 is airtight.
In summary, referring to FIG. 1, 3, or 5, upon donning the device 100 via straps 1 and 2, the user will insert his/her elbow into the elbow elevating support 300 and adjust its height via tugging on strap 3. After this gross adjustment of the shoulder sling device 100 is completed, the user will inflate the air bladder 8 within the shoulder sling portion 200 via multiple depressions of inflation means 14 which will preferentially distribute air to desired air bubble 10 areas due to a differential negative pressure gradient. When the desired snug fit is achieved, the user will cease to depress the inflation means 14 and pressure will be retained via one way valve 18, and a small amount of air will be retained in the inflation means chamber. The fit will thus remain snug throughout the use of the apparatus. Comfort of use is granted via a comfortable inner textile layer at both the elbow elevating support 300 and shoulder sling 200, as well as ventilation holes 11 at the shoulder sling 200 that will allow the escape of warm air, prevent sweat buildup, and allow physiologic cooling. If the inflated pressure if too high, or if the user desires to remove the device, he/she will depress the pressure releasing means 18 which will allow the escape of air from the said air bladder and decrease the pressure.
Having thus described details of preferred embodiments in accordance with the scope of the present invention it is apparent that it provides numerous benefits over, and addresses inadequacies of the prior art. It should be apparent to one skilled in the art that various adaptations of modifications of the present invention can be made and will still fall within its scope, which is limited only by the appended claims:

Claims

1. An inflatable device used to prevent joint subluxation designed to encompass and contour to one or more body surfaces on each side of the desired joint to be treated, spanning a plurality of joints and containing a plurality of straps that envelop both anterior and posterior surfaces of the user's body

2. The inflatable device of claim 1 containing a portion used to prevent joint subluxation in one joint, further containing a portion used to provide lift across an additional joint, herein called the elevating support portion spanning one or more body surfaces on each side of said joint

3. The inflatable device of claim 2 wherein said plurality of straps are further comprised of a length adjusting means that allows the shortening and lengthening of said plurality of straps

4. The inflatable device of claim 3 wherein said plurality of straps further comprise an attachment means which insert into an attachment means retaining element located on said joint subluxation prevention portion of said device after enveloping said user's body, after which said device will remain secured to said user's body and function to maintain the integrity of the joint.

5. The inflatable device of claim 4 wherein said plurality of straps extend across a patient's dorsum and emerge anteriorly

6. The inflatable device of claim 5 wherein said joint subluxation prevention portion and elevating support portion are comprised of a plurality of non-continuous layers, each made of a unique material not common to another

7. The inflatable device of claim 6 wherein the interior most of said plurality of non-continuous layers contacts the user's body surface and is comprised of a pliable material with the purpose of providing comfort to user.

8. The inflatable device of claim 7 wherein the exterior most of said plurality of non-continuous layers comprises a material that is less pliable than that of said interior most layer and serves to provide some rigidity and maintain the form of the said device

9. The inflatable device of claim 8 further comprising a layer comprising a cushioning means

10. The inflatable device of claim 9 where said cushioning means comprises a cushioning means housing that contains malleable material

11. The inflatable device of claim 10 where said malleable material comprises a highly viscoelastic pliable polymer gel

12. The inflatable device of claim 10 where said malleable material comprises flexible soft foam

13. The inflatable device of claim 6 further comprising an air bladder that is continuous throughout its construction, forming a continuous air bladder space and formed of an airtight polymer material.

14. The inflatable device of claim 13 wherein said air bladder is comprised of equidistantly arranged air bubbles that comprises an air bubble inlet that is continuous with said continuous air bladder

15. The inflatable device of claim 14 further comprising a manual inflation means located on said joint subluxation prevention portion continuous with said continuous air bladder space that is operated by a user utilizing one or more fingers

16. The inflatable device of claim 15 wherein said manual inflation means is comprised of a semi-rigid collapsible inflation means housing that is depressed and elevated by said user operation and encloses a inflation means chamber that comprises atmospheric air

17. The inflatable device of claim 16 wherein the said manual inflation means is maintained in position by a inflation means retaining element

18. The inflatable device of claim 17 wherein said manual inflation means comprises a plurality of one way valves, whereby the depression of said manual inflation means will force captured said air in said inflation means chamber through said valves into said continuous air space and prevent its escape to the external environment, wherein said air will inflate said air bladder and said air bubbles pushing and deforming said malleable material against the user's body part, whereby said air bubbles will inflate according to individual pressure requirements against said user's body and provide a fit that is customized to an individual's body contours and asymmetries to provide uniform support of the joint and reduce the chance of development of pressure ulcers and joint subluxation.

19. The inflatable device of claim 18 further comprising a pressure releasing means located on said joint subluxation prevention portion continuous with said continuous air bladder space that is operated by a user utilizing one or more fingers

20. The inflatable device of claim 19 wherein said pressure releasing means is located adjacent to said manual inflation means.

21. The inflatable device of claim 20 wherein said pressure releasing means is comprised of a semi-rigid pressure releasing means housing that is depressed and elevated by said user operation

22. The inflatable device of claim 21 wherein said pressure releasing means housing further comprises of a plurality of pressure releasing air outlets

23. The inflatable device of claim 22 wherein said pressure releasing means is comprised of a pressure releasing valve that will allow the escape of captured air in said air bladder when operated by user

24. The inflatable device of claim 23 wherein said pressure releasing means further comprises a buoyant pressure retaining means which retains said pressure releasing valve in an orientation that prevents the escape of said captured air when said pressure releasing means is not operated by the user

25. The inflatable device of claim 24 further comprising a pressure releasing means retaining element that maintains the pressure releasing means in place and furthermore contacts said pressure releasing valve when said pressure releasing means is not operated by the user such that the escape of said captured air is prevented

26. The inflatable device of claim 25 wherein said pressure releasing valve comprises an air passage means through which said captured air will escape

27. The inflatable device of claim 6 wherein said joint subluxation prevention portion and said elevation support portion is comprised of ventilation holes that passes through all said layers, allowing for the cooling of said user's skin

28. The inflatable device of claim 11 wherein said elevating support portion comprises a strap retaining means that allows the passage of one of said plurality of straps throughout its entire length